Dr. Bruce Campbell had some interesting feedback in his blog, Reflections in a Head Mirror
. A reader writes, "As a female I have always worried about passing on a yeast infection to the performing partner, although that never happend to me, it happened so a few people I knew when their husbands came down with a bad case of thrush. ... I would usually get a bladder infection, something I am prone too, after receiving oral sex. After avoiding oral sex, my incidence of bladder infection is way, way down. I really think there is a link, and women seem to have bladder infections a lot."
There was actually some exchange of e-mails from professionals on an Internet community board for ISSWSH (the International Society for the Study of Women's Sexual Health, to which I belong) about a patient who was getting frequent urinary tract infections.
She had the million dollar work-up to rule out stones, reflux, incomplete bladder emptying. Turns out, the patient had a partner who had a tongue piercing. When they cultured the tongue accessory, it came back as the same bacteria that the patient had been growing. So lesson to all of us out there ... yes, oral sex may be the reason a person is having frequent infections. I certianly ask about sexual practices now with my patients who present with frequent urinary or vaginal infections (there are penile piercings, use of vibrators and other paraphernalia as well that needs to be discussed).
As for Dr. Campbell and his response to his reader, I appreciate his candor and honesty. In his defense, physicians (acutally, most people, not just the medical profession) are embarrassed to talk about sex and sexual practices because of the following reasons:
- It is still considered taboo in our culture
- Frankly, we are not taught how to in medical school
- Because MDs don't want to open the patient's pandora's box (affairs, unknown STD's, fetishes ...)
- The disease the patient has in front of the treating physician is the focus at that moment
- Most MDs are not comfortable/trained/feel competent talking frankly about sex
- If there is a problem, most MDs don't have the training to know what to do (especially when it comes to female sexual medicine)
- Sexuality and fertility are typically the last thing other physicians think about when they are trying to just save their patient's life
When I talk to other physicians, I tell them to typically just pass them on to our clinic (or to the Reproductive Medicine Center in cases of fertility questions) or at least give the patient our number as a future resource.
This is what we do in our clinic every day. And as much as I don't expect to talk to my patients about their diabetes, high blood pressure or other things, I don't expect other physicians to talk to their patients openly about their sexual habits. There is a difference between asking if they have diabetes or if they are sexually active (what we call screening questions) versus getting into their daily blood sugar levels or inquiring if they masturbate and perform oral sex on a regular basis.
It is improtant for patients and physicians to know that at least at Froedtert & The Medical College of Wisconsin, we have this resource. As an academic medical center, we have that resource and not many centers in Wisconsin or in the United States have a comprehensive program where we treat not just men, but also women.